Diagnostic yield of methylene blue chromoendoscopy for detecting specialized intestinal metaplasia and dysplasia in Barrett's esophagus: a meta-analysis
Diagnostic yield of methylene blue chromoendoscopy for detecting specialized intestinal metaplasia and dysplasia in Barrett's esophagus: a meta-analysis
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DOI：
10.1016/j.gie.2008.06.056
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发表时间：
2009-05-01
影响因子：
7.7
通讯作者：
Das, Ananya
中科院分区：
文献类型：
--
作者：
Ngamruengphong, Saowanee;Sharma, Virender K.;Das, Ananya
背景资料：亚甲基蓝（MB）染色内镜靶向活检在检测特化肠上皮化生（SIM）和更重要的是Barrett食管（BF）患者异型增生方面的报告产量显示了可变的结果。目的：对已发表的研究进行荟萃分析，以评估色素内镜技术与传统四象限随机活检（RB）相比的诊断率在BF患者中检测SIM和异型增生。设计：MEDLINEEMBASE的文献检索，科克伦数据库进行沿着检索PAW和手动检索符合条件的文献的交叉引用，提取并分析两种模式的Dam on Odd，以估计加权增量收益（IY）和95%采用固定效应或随机效应模型，根据同质性或异质性，分别采用科克伦Q卡方（2）检验表示MB相对于RB的CI。患者：在荟萃分析中纳入的9项研究中，共报告了450例BE患者。（IY4%; 95% CI，-7%至16%; 6项研究，n = 251），异型增生（IY 9%; 95% CI，-1%至20%; 9项研究n = 450）和高度异型增生和/或早期癌症（IY 5%; 95% CI，-1%至10%; 8项研究，n = 405）。局限性：由于其他色素内镜染料的数据有限，入选和排除标准的微小变化，结论：在BE患者的内镜检查中，NIB染色内镜技术在SIM和异型增生的检出率仅与RB相当。（Gastrointest Endosc 2009;69;102-8.）
Background: The reported yield of methylene-blue (MB) chromoendoscopy targeted biopsy in detecting specialized intestinal metaplasia (SIM) and, more importantly dysplasia in patients with Barrett's esophagus (BF) has shown variable results.Objective: To perform a meta-analysis of published studies for assessment of the diagnostic yield of techniques of chromoendoscopy compared with conventional 4-quadrant random biopsy (RB) in detection of SIM and dysplasia in patients with BF.Design: A literature smirch of Me MEDLINE EMBASE, and the Cochrane Databases was performed along with a search of PAW and a manual search of cross-references of eligible articles Dam on Odd of both modalities were extracted and analyzed to estimate weighted incremental yield (IY) and 95% CIs of MB over RB using a fixed-effects or random-effects model, as appropriate, based on whether homogeneity or heterogeneity, respectively was indicated by Cochrane's Q chi(2) test.Patients: A total of 450 patients with BE were reported in 9 studies included in the meta-analysis.Results: There was no significant IY with MB over RB for detection of SM4 (IY4%; 95% CI, -7% to 16%; 6 studies, n = 251), dysplasia (IY 9%; 95% CI, -1% to 20%; 9 studies n = 450), and high-grade dysplasia and/or early cancer (IY 5%; 95% CI, -1% to 10%; 8 studies, n = 405).Limitations: Only data on MB were analyzed because of limited availability of data for other chromoendoscopy dyes, minor variations in inclusion and exclusion criteria, and the small sample son and because differences in application technique could have led to an underestimation of the diagnostic yield of MB chromoendoscopy.Conclusion: The technique of NIB chromoendoscopy has only a comparable yield with RB for the detection Of SIM and dysplasia during endoscopic evaluation of patients with BE. (Gastrointest Endosc 2009;69;102-8.)